Posts Tagged: Affordable Care Act

Retiree Only Plans – Time is Running Out

in Affordable Care Act, Retiree Benefits

The so-called “retiree-only” plan exception has been around since HIPAA was passed back in 1996.  However, it has taken on new importance now that a retiree-only plan can also be exempt from the provisions of the Affordable Care Act.  But, what is this amorphous being?  In the past some employers have claimed that this exception applies at the benefit option level even if retiree options are wrapped together with active employee options in the same ERISA plan.  This position is certainly harder to maintain under the proposed DOL regulations defining a “plan” for Part 7 purposes.  But, clearly if an employer… Continue Reading

IROs – Relief or Confusion?

in Affordable Care Act

Late Tuesday, DOL released FAQs regarding various miscellaneous ACA issues.  DOL also released additional guidance on the claims and appeals procedures in Technical Release 2010-02.   THe FAQs can be seen here: http://www.dol.gov/ebsa/faqs/faq-aca.html The FAQs are a strange aggregation of items.  One of the FAQs states that with respect to IRO contracts that the earlier DOL guidance never required a contract between a plan and an IRO.  This is in direct contradiction with Technical Release 2010-01 which specifically states that a contract between a plan and an IRO must contain specific language as set forth in the release.  If a contract… Continue Reading

Nondiscrimination for Insured Plans – Update

in Affordable Care Act

A few weeks ago we informed you of the delay in regulations regarding the insured plan nondiscrimination rules.  Yesterday, the IRS published Notice 2010-63, requesting information regarding how the new nondiscrimination rules should apply to insured plans and the interaction with 105(h).  Comments are due by November 4, 2010.  The IRS is likely looking at how it can combine nondiscrimination testing when a single sponsor has multiple insured options and/or multiple insured and self-insured options.  Based on the timing for comments, i would not expect regulations to be issued until the early part of 2011.  Link to Notice 2010-63 is as… Continue Reading

Nondiscrimination for Insured Plans

in Affordable Care Act

New PHSA Section 2716 adopts new nondiscrimination rules on insured health plans beginning with the first plan year after September 23, 2010 (or January 1, 2011 for calendar year plans). The statute provides that rules similar to the Code Section 105(h) rules for self-insured plans shall apply for this purpose. We thought that the regulations implementing this new requirement were to be released soon. However, last week we heard, unofficially, that the regulations have been delayed, meaning that employers with insured plans have no idea whether their health plans will satisfy the new regulations when annual enrollment season begins next month…. Continue Reading

Mini-Med Waivers and OTC Reimbursements Explained

in Affordable Care Act

As noted previously, IRS announced the OTC reimbursement guidance for health FSAs and HRAs, and HHS announced the mini-med waiver program. Unfortunately, there is not much substance in the guidance, leaving many plan sponsors with numerous questions as they approach annual enrollment. We have posted our Legal Alert on these releases at the link below. Reimbursing OTC Drugs and Applying for Mini-Med Waivers